shakorox
01-06-2006, 06:04 PM
I left a message today for my Doc to refill my Lortab 10/500 q 6hrs. Over the past month my liver enzyme ALT has risen to 70 the upper limit of normal at my lab is 53 I believe. So my doc called on her way out and unfortunatley I was on the other line trying to get through to her at her office (go figure) so she left a message saying that she didn't want to refill the meds due to the tylenol. She wan't me to check with my GI Doc (who's out of the office till 1/30). I was on Oxycontin 20mg BID before but my Doc switched me to the Lortab's cause of my nausea. So now I'm outa meds and a weekend full of pain ahead of me . . .ugh!
So I'm sure she'll call me on monday morning to discuss this with me. Anybody know what would be good on the pain and easy on the liver? Just so you know my doc isn't sure what causes the pain but I do have some strange fusions on my transverse proceses in my lower vertebra, I forget at what levels but they are only on the left side. My pain radiates from the lower left side and spreads down to my left foot . . .oucha!
Sorry gotta cut it short, any sugestions? I'll check in later.
Thanks ya'll
So I'm sure she'll call me on monday morning to discuss this with me. Anybody know what would be good on the pain and easy on the liver? Just so you know my doc isn't sure what causes the pain but I do have some strange fusions on my transverse proceses in my lower vertebra, I forget at what levels but they are only on the left side. My pain radiates from the lower left side and spreads down to my left foot . . .oucha!
Sorry gotta cut it short, any sugestions? I'll check in later.
Thanks ya'll
Sponsor
Director
01-06-2006, 07:20 PM
Shakorox: You said you were taking Lortab 10/500. If you're trying to lower the Tylenol level, they do make Hydrocodone 10/325 or you can have a compound pharmacy make up Hydro and Tylenol in any dose you want. I've heard a lot of people doing this and it seems they go with 10/80. 10 mg of Hydro and 80 mg of Tylenol or Acetaminophen. They do tend to be a little on the expensive side though.
Another option would be to go to Oxycodone IR. Tablets come in 5, 15, and 30 mg doses. Not sure what made you sick when you were taking Oxycontin, but this might be an option for you.
If neither of these work for you, there are still a lot of other meds you could try, both LA and SA. A lot of people here could give you some suggestions. Take care and I hope the weekend isn't too bad. Any chance you could call her service and get ahold of your doc that way?
Another option would be to go to Oxycodone IR. Tablets come in 5, 15, and 30 mg doses. Not sure what made you sick when you were taking Oxycontin, but this might be an option for you.
If neither of these work for you, there are still a lot of other meds you could try, both LA and SA. A lot of people here could give you some suggestions. Take care and I hope the weekend isn't too bad. Any chance you could call her service and get ahold of your doc that way?
shakorox
01-06-2006, 11:55 PM
Thanks Director, I'm not sure what made me sick with the oxycontin either :confused: I was always nauses while on it, maybe I needed to wait it out longer but when I told my Doc about it she switched me back to the hydro! I work at a hospital and get a huge discount at the outpatient pharmacy, a months supply usually only costs 5 or 6 bucks. I wonder if they do compounding there? Does insurance usually cover compounded meds? How about those transdermal patches as an alternative? Are the side effects of the patch comparable or milder to those of oral meds?
I appreciate the input,
Thanks,
Derek
I appreciate the input,
Thanks,
Derek
pedden
01-07-2006, 12:25 AM
My ex-mother-in-law actually takes 20mg Hydrocodone Capsules that she has compounded with no APAP (Tylenol) at all in it. Her BC&BS covers this medicine here in NC. Like I said it was the strangest thing I had ever seen and I had never heard of it before, but it was there in my face. Just plain 20mg of Hydrocodone, made at a compounding pharmacy and it was in a capsule not a tablet. Hope this helps spread some insight on the possibilities.
Sincerely,
Jonathan Motte :) :wave:
Sincerely,
Jonathan Motte :) :wave:
feelbad
01-07-2006, 10:33 AM
Its too bad you couldn't actually speak with her about alternatives before she just toally cut you off like that.that really IS an appalling thing to do to a patient in pain.if she did not want to actually Rx the hydro she should have had the decency to at least RX you something??i am kind of wondering about your other labs,are they all in the norm ranges and within like the middle of range or are they still in range but on the higher side?Why were the labs done in the first place?was this just routine or was there an underlying reason that prompted these tests?Sorry for all the questions but I am just a bit concerned about your liver thats all.Did she happen to mention just what may be causing the high alt?i do believe that the high end of norm for both the ALT and the AST are both in the low to mid forties.While this could be just the effects of the tylenol,you really do need to have a bit more in depth testing done just to make certain.I really do think that you may want to consider getting an ultrasound just to actually see what the liver looks like itself.espescially if your ALT continues on this upward trend or other labs are close to being out of the norm ranges.generally any lab changes wont occur til any sort of actual damage gets to a certain level.If there is actually ongoing destruction to your liver cells and this goes unrecognized or even continues when you have even gone off the tylenol,there could possibly be some sort of underlying liver and or kidney disease.Were your kidney labs done too?if not they need to be as tylenol is actually harder on the kidneys than the liver,mostly due to the fact that with the liver,it can regenerate itself,but the kidneys cannot.you do need to at least have these labs checked as well.You just want to make darn sure that everything is okay,espescially if you need to continue on with any sort of meds.hopefully this high ALT is just situational and any damage will resolve itself once you have been off the tylenol for about six weeks.
I am a bit curious about the reaction you had to the oxycontin?do you remember if this was the actual name brand version or a generic version?I am only asking because if it was a generic,espescially if it was made by Endo? the nausea could have been just related to THAT particular generic and not the actual med itself.I have been on OC for almost two years now,with no problems whatsoever,up til I was given the generic version from endo,it is oxy ER.i had the absolute worst nausea from that crap,along with much less pain control.alot of people who have tried this particular version have the same exact reaction.This would be worth checking out,really.you could try having your doc Rx name brand only to see if this change would resolve the nausea issue.if you did indeed have the endo,(which I believe was the first med co to come out with the first generic version of oxycontin,as it appears that anyone who was given a generic version seems to all been on the endo first).This could very well be the reason.if you cannot remember just what brand you were given,just go to the pharm that filled that Rx and ask them just what generic they use or used at that time.This could totally change your pain treatment so it would be worth a shot espescially since you are going to have to go onto something else.good luck and let us know how things go,K? FB
I am a bit curious about the reaction you had to the oxycontin?do you remember if this was the actual name brand version or a generic version?I am only asking because if it was a generic,espescially if it was made by Endo? the nausea could have been just related to THAT particular generic and not the actual med itself.I have been on OC for almost two years now,with no problems whatsoever,up til I was given the generic version from endo,it is oxy ER.i had the absolute worst nausea from that crap,along with much less pain control.alot of people who have tried this particular version have the same exact reaction.This would be worth checking out,really.you could try having your doc Rx name brand only to see if this change would resolve the nausea issue.if you did indeed have the endo,(which I believe was the first med co to come out with the first generic version of oxycontin,as it appears that anyone who was given a generic version seems to all been on the endo first).This could very well be the reason.if you cannot remember just what brand you were given,just go to the pharm that filled that Rx and ask them just what generic they use or used at that time.This could totally change your pain treatment so it would be worth a shot espescially since you are going to have to go onto something else.good luck and let us know how things go,K? FB
shakorox
01-07-2006, 10:29 PM
Thanks FB, I didn't think about the Kidneys. I should get those checked out. The reason I had the labs was for GI bleeding (if you know what I mean). I had an upper and lower scope that ruled out anything serious. They only found esophigitis and the pathology revealed gastritis in the stomach. Unfortunatly my GI Doc has been out of town since I had the endoscopies and he won't be back till the 30th! I guess I have to ask whoever is filling in for him. It apears my back Doc wants me to consult with him before she RX's :confused: However before the GI Doc left he told me to stay far away from NSAID's.
Concerning the oxycontin, the 10mg pills BID that I started on where Ivax Pharmacuticals, however they where not making the grade so after 3 weeks my Doc switched me to the 20mg's. I got the script filled on a saturday therefor couldn't fill them at work/hospital. Instead I got them filled at Ballgreens. When I went to pick them up I brought the remaining 10mg pills to the pharmacy per my doctors request adn when I read the packaging on the new 20's they were the Endo brand. And they where the ones that made me nauses and get killer H/A's :eek: A week later I told my Doc how they made me feel and she switched me to Lortabs 10/500, I've been takeing those Q 6hrs for the past two months.
My pain is constant and controling and I've always been willing to try any modality to reduce my p-level and be more functional. I use a cane when I have to walk any significant distance to reduce the pressure on the left side of my body. I also use a Tens-unit, ice, heat, etc. For years I didn't have insurance and had to find my own ways to deal. I'm very grateful that I now can see a Doc who seems concerned about my pain. I've accepted that it will always be there, and expect to always deal with a certian level of pain. My goal is to remain as fully functional as I can.
I'll cut it off here, sorry about being long-winded. I sorta deviated from the topic.
Later guys,
Derek
Concerning the oxycontin, the 10mg pills BID that I started on where Ivax Pharmacuticals, however they where not making the grade so after 3 weeks my Doc switched me to the 20mg's. I got the script filled on a saturday therefor couldn't fill them at work/hospital. Instead I got them filled at Ballgreens. When I went to pick them up I brought the remaining 10mg pills to the pharmacy per my doctors request adn when I read the packaging on the new 20's they were the Endo brand. And they where the ones that made me nauses and get killer H/A's :eek: A week later I told my Doc how they made me feel and she switched me to Lortabs 10/500, I've been takeing those Q 6hrs for the past two months.
My pain is constant and controling and I've always been willing to try any modality to reduce my p-level and be more functional. I use a cane when I have to walk any significant distance to reduce the pressure on the left side of my body. I also use a Tens-unit, ice, heat, etc. For years I didn't have insurance and had to find my own ways to deal. I'm very grateful that I now can see a Doc who seems concerned about my pain. I've accepted that it will always be there, and expect to always deal with a certian level of pain. My goal is to remain as fully functional as I can.
I'll cut it off here, sorry about being long-winded. I sorta deviated from the topic.
Later guys,
Derek
feelbad
01-08-2006, 10:30 AM
i really do think from what you have stated that giving the OC another try but making sure you get the brand name only(all the doc has to do is write DAW"despense as written" on the Rx)and try that and see if you get those same effects,i am willing to bet that it was the endo crap that actually caused your nausea and headaches.This stuff does not have a good track record with just about anyone I have had contact with who have been treated with the stuff.i just simply cannot take it at all.My PM always writes the DAW onmy Rxes and i have no problems or side effects at all.This really really would be your best option considering your current liver status.talk with your doc about trying the name brand and see what happens.
Was your GI bleed bright red blood or did it look like coffee grounds or just black?i hope things workout for you,and yes you should definitely get the labs done on your kidneys as well.along with an ultrasound done on both.this will give you a much better picture of what is going on,if anything.Marcia
Was your GI bleed bright red blood or did it look like coffee grounds or just black?i hope things workout for you,and yes you should definitely get the labs done on your kidneys as well.along with an ultrasound done on both.this will give you a much better picture of what is going on,if anything.Marcia
Blasterboy
01-08-2006, 02:02 PM
My Alt bounces all over the place from between 50 and 110. Apparently it's no big deal, certainly it doesn't concern my Doctor, but we do keep an eye on it.
madhatter
01-09-2006, 07:07 AM
I too,a'm taking oxycotin,and a while back my script was filled generic. From what other peaple tell me,the endo version is the best generic.But i was getting an upset stomache from it,i guess its the fillers in it. My doc. said most of her patients on oxycotin had the same complaint of the generic,so she wrote my next script D.A.W but she warned me,since i take them tid,that other patients she wrote as D.A.W the insurance co. would only fill brand name as the maker suggests,one every 12 hrs. But my insurance co. [comp] filled mine tid, with no problem. As far as insurance covering compound med. If you go that route,have your doc. write a little note explaining why you have to get them compounded[tylonol issue] and you should have no problem. Goodluck,let us know how youmake out.